How do you define central lung cancers when considering SBRT?

Interestingly, I have never fully subscribed to the 2.0 cm "no-fly zone" concept and it was based on the need to ensure the safety of patients in our early experience. If one looks at the literature, the original All-Japan study did not differentiate between central and peripheral locations. The ori...

I follow IASLC ART committee recombination (Chang et al., PMID 25514807) and define "central lesion" as within 2 cm of critical structures including bronchial tree, esophagus, heart, major vessels, spinal cord, and brachial plexus. Severe toxicities have been reported with these critical structures ...

Definitions are nice for studies and publications. However, for managing individual patients, I contour the PBT to the end of the lobar bronchi, stopping at the orifices to the segmental branches. I then expand the PBT + 10 mm with a dummy volume to see its proximity with the PTV. At this point, I d...